HLA-DR7 in association with chlorpromazine-induced lupus anticoagulant (LA).
The presence of anti-phospholipid antibodies (aPL) has been associated with the major histocompatibility complex (MHC) genes. These autoantibodies occur in individuals with infections such as that produced by the human immunodeficiency virus 1 (HIV-1) or with syphilis, but they can also occur in drug-induced lupus-like syndromes. In the present study, we analysed the presence of aPL (detected as lupus anti-coagulant) and its relationship with the MHC markers in 93 Caucasian psychiatric patients chronically treated with chlorpromazine. Forty-one out of 93 patients were positive for LA, and the HLA-DR7 antigen was significantly increased in LA-positive patients as compared to normal controls or LA-negative patients (PC = 0.024, RR = 2.12 and P = 0.05, RR = 1.57, respectively). Likewise, we noted a significantly increased frequency of HLA-B44 in LA-positive patients as compared to normal controls (PC = 0.024, RR = 2.12), but not when compared to aPL-negative patients. No significant differences were found among any other class I, II or III MHC antigens. Haplotype analysis showed that DR7 was mostly part of the HLA-B44-DR7-FC31 and B7-DR7-SC31 haplotypes. These results suggest that the HLA-DR7 antigen might be playing a role in the production of aPL in chlorpromazine-treated patients.
Vargas-Alarcón
G
G
Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
Yamamoto-Furusho
J K
JK
Zuñiga
J
J
Canoso
R
R
Granados
J
J
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000097:blood / Q000188:drug therapy; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy; D002648:Child; D002746:Chlorpromazine / Q000009:adverse effects* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005805:Genes, MHC Class I / Q000187:drug effects / Q000502:physiology; D005802:Genes, MHC Class II / Q000187:drug effects / Q000502:physiology; D015809:HLA-DR7 Antigen / Q000097:blood*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000096:biosynthesis*; D008297:Male; D019965:Neurocognitive Disorders / Q000097:blood / Q000188:drug therapy; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy
D015809:HLA-DR7 Antigen; D016682:Lupus Coagulation Inhibitor; D002746:Chlorpromazine